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Confidentiality in Your Nursing Job

Confidentiality is an issue that anyone considering a nursing job needs to seriously think about. If you have great difficulty knowing and understanding what you can discuss openly and what you need to keep to yourself, a nursing career may not be right for you.

In recent years, confidentiality within nursing has become even more of an issue with the advent of tighter privacy rights and HIPAA regulations. Curiosity is a natural human response, but knowing when it’s appropriate to seek out information and when it’s not, is an important factor in professionalism in the health care field.

Patients need to trust their health care providers, and nurses have long been listed as one of the most trusted among all professions. To maintain that status, nurses must understand confidentiality issues.

Some breeches of confidentiality in the past year have been newsworthy. Information leaks regarding celebrities such as Britney Spears and Gov. Arnold Schwarzenegger came to light, and several nurses and other health care employees were fired from such places as UCLA Medical Center for breeches of confidentiality.

Some of those who were disciplined or fired did nothing more than access medical records. The point being, however, is “the need to know.” If you have no need to know anything about a patient in your facility in relationship to your job, then you have no need to be accessing the medical records.

It might be fascinating to learn the home address or phone number for a certain celebrity. You might only use the information to drive by the property and just look, but you have no right to have that information. This is considered a breach of confidentiality.

If you are caring for that patient, and need to call his home or contact his next of kin about matters related to patient care, that’s a different story. You need to access the information, but you also need to not keep or use the information for any other purpose.

You also can not share the fact that this person was your patient with your family and friends.On the same note, you cannot discuss the details of any patient with your family and friends.All patients have the same right to privacy.

You must also be careful not to discuss any patient with other patients. For example, the patient in Bed 2 wants to know where his “roommate” has gone.You cannot tell him that he went for X-rays or therapy. You simply need to say, “I’m not sure.” Perhaps the roommate will share this information when he returns, but that’s his business, not yours.The same goes for the status or any other personal information. You simply cannot comment or share.

This can be quite common for home health nurses as well. A friendly neighbor greets you as you enter or leave your patient’s home inquiring about the status of your patient. Technically, you can’t even acknowledge that you are a nurse. You just have to suggest that the inquisitive neighbor call or visit the patient to find out for himself.

On the other hand, if a patient gives you permission to discuss his status or care with hospital roommates or neighbors, then you may do so, but only with those whom he has specifically permitted. You must carefully document the fact that this permission was given and specify what you told this person, and that you have informed the patient of your discussion.

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Comments

This is a huge issue. To receive emotional support I fall into the trap of explaining an issue, and wondering whether I revealed any item of privacy. If I say what part of the city and include something unusual about the client's circumstances, that may be enough to breach confidentiality. Even if nobody finds out; I can feel bad in my conscience.